Kornimate/medical-research-clean huggingface dataset:
effect of continuous positive airway pressure for treatment of obstructive sleep apnea on resistant hypertension

Conditions: Resistant Hypertension; Obstructive Sleep Apnea

Summary: the objectives of this study are to investigate the effect of continuous positive airway pressure (cpap) treatment on blood pressure control and vascular inflammation in subjects with resistant hypertension and moderate obstructive sleep apnea (osa).

resistant hypertension is defined as blood pressure that remains above goal in spite of concurrent use of 3 antihypertensive agents of different classes. resistant hypertension is defined in order to identify patients who are at risk of having secondary causes of hypertension, and who may benefit from specific diagnostic and therapeutic applications. despite the fact that osa is listed as one of the causes of resistant ht , paucity of works has demonstrated the magnitude of problems of untreated osa in subjects with resistant ht. there is so far two study demonstrating the beneficial effect of cpap treatment in subjects with resistant ht, though both studies were flawed by not including the control group, no randomization and limited sample size. we aim at conducting a randomized controlled study to explore the beneficial effect of cpap treatment in subjects with osa and resistant hypertension.

Eligibility criteria:
inclusion criteria: * age 18 - 65 * known hypertension on ≧ 3 anti-hypertensive drugs * apnea-hypopnea index ≧15 * able to give informed written consent exclusion criteria: * moderate renal impairment (glomerular filtration rate \<30 ml/min/m2 ) * endocrine/renal/cardiac causes of secondary ht * congestive heart failure and clinically fluid overloaded * on drugs that elevates bp e.g. nsaid, steroid * non-compliance to anti-hypertensive medications * unstable medical conditions such as unstable angina, recent myocardial infarction/stroke within 3 months * active inflammatory/infective conditions e.g. rheumatoid arthritis * excessive sleepiness that can be risky e.g. occupational driver, machine operator * modification/changes of anti-hypertensive regimen within 8 weeks

Keywords: obstructive sleep apnea resistant hypertension refractory hypertension continuous positive airway pressure blood pressure control
neuroprotective effect of butylphthalide for cardiac arrest patients

Conditions: Butylphthalide; Cardiac Arrest; Neuroprotective Drugs

Summary: cardiac arrest is one of the critical illnesses that is directly life-threatening, and patients who survive cardiac arrest develop severe neurological deficits or even die. the effectiveness of drugs to improve neurological function in resuscitated brain-injured patients has been a focus of research in the field of resuscitation. butanephthalein has an ameliorating effect on the damage of central nervous function in patients with acute ischemic stroke, and can promote the improvement of patients' neurological deficits. on this basis, the present study was designed as a multicenter, prospective randomized controlled experiment, with internationally accepted methods for assessing near-term and long-term neurological function, to determine the effectiveness of butalbital in improving neurological function after cardiac arrest, with the aim of searching for new methods and ideas to improve neurological function and prognosis after cardiac arrest.


Eligibility criteria:
inclusion criteria: 1. age 18-80 years old. 2. glasgow coma scale (gcs) scores ≤8 upon admission. 3. return of spontaneous circulation (rosc) ≥30min. 4. signed the informed consent form. exclusion criteria: 1. cardiac arrest due to irreversible causes such as trauma, poisoning, etc. 2. cardiac arrest due to end-stage conditions such as advanced cancer. 3. persistent cardiogenic shock that is unreversed (defined as a systolic blood pressure persistently \<90mmhg despite treatment with fluid resuscitation, vasopressor agents, and inotropic medications). 4. presence of pre-existing cerebrovascular disease prior to cardiac arrest or confirmed intracranial hemorrhage by ct scan following admission. 5. pre-existing cpc scores of 3-5 prior to cardiac arrest. 6. prior use of nbp or any medication containing nbp before cardiac arrest. 7. presence of severe hepatic or renal dysfunction before cardiac arrest (defined as ≥3× upper limit of normal alanine transaminase or ≥2× upper limit of normal creatinine). 8. bradycardia or sick sinus syndrome occurs after rosc. 9. history of prior drug or food allergies, or known allergies to the medication components used in this study. 10. existence of treatment limitations (patient or their legal representative refusing advanced life support treatment, including mechanical ventilation, chest compressions, targeted temperature management, etc.). 11. presence of severe bleeding tendency upon admission. 12. body temperature \<30℃ upon admission. 13. pregnant or lactating women, or reproductive-age females with elevated serum human chorionic gonadotropin (hcg) levels. 14. other conditions deemed unsuitable for this trial by the principal investigator.
first line tip in poor prognosis tgcts.

Conditions: Germ Cell Tumor

Summary: tip in the 1st line treatment of gcts patients with unfavorable decline of serum tumor markers after 1 cycle of the bep regimen.tip will be administered to the patient until progression, unacceptable toxicity, complete response or inability of the subject to comply with study requirements.

cycle 1: bep regimen serum tumor markers at day 18-21: •patients with an unfavorable pattern of tumor marker decrease after 1 cycle of bep will receive 4 more cycles of tip. tip regimen: * taxol 250 mg/ m2 iv on day 1 * ifosfamid 1,2 g/ m2/ day iv x 5 days * cisplatin 20 mg/ m2/ day iv x 5 days one cycle of therapy consists of 22 days. estimated duration of treatment: until progression, unacceptable toxicity, complete response or inability of the subject to comply with study requirements.

Eligibility criteria:
inclusion criteria: * patients older than 16 years. * evidence of nsgct based on histologic examination or based on clinical evidence and high serum hcg or afp levels (in case of clinical emergency, therapy can be started before pathologic sample is obtained if tumor markers are very elevated) * testicular, retroperitoneal, or mediastinal primary site. * evidence of disseminated disease (clinical stages ii or iii). * disease classified as poor prognosis according to igcccg criteria: * primary mediastinal nsgct or * non-pulmonary visceral metastases or * hcg \> 50,000 ui/l, or afp \> 10,000 ng/ml, or ldh \> 10 times the upper normal value. * no prior chemotherapy. * no previous carcinoma, except basal-cell carcinoma of the skin. * adequate renal function: measured or calculated creatinine clearance\> 60 ml/min. * absolute granulocyte count \>= 1,500/mm3, platelets \>= 100,000 mm3, bilirubine \<= 1.5 fold the upper normal value. * unfavorable tumor marker decline after 1.cycle of bep * signed informed consent. exclusion criteria: * patients infected by the human immunodeficiency virus (hiv). * patients who do not fit inclusion criteria.

Keywords: poor-prognosis germ cell cancer, paclitaxel, ifosfamid and cisplatin regimen, tumor marker decline
bioflow-china post-marketing study (biotronik)

Conditions: In-Stent Stenosis (Restenosis) of Coronary Artery Stent; Native Coronary Artery Stenosis

Summary: this trial uses prospective, retrospective, observational, non-blinded, multi-center, single-arm, post-marketing hospital data collection and research methods. the goal of this study is to assess the safety of biotronik orsiro sirolimus-eluting coronary stent system in the chinese patient population after marketing in china.

this trial uses prospective, retrospective, observational, non-blinded, multi-center, single-arm, post-marketing hospital data collection and research methods. a total of 2,000 subjects will be enrolled from up to 15 research sites in china. suitable subjects will be selected according to the inclusion and exclusion criteria, and those who meet the inclusion and exclusion criteria will accept follow-up after signing the informed consent form from the site ethics committee until 5 years after surgery. it is aimed to further assess the safety of biotronik orsiro sirolimus-eluting coronary stent system in the chinese patient population after marketing in china by observing the data collected in this trial.

Eligibility criteria:
inclusion criteria: * the subject should be 18 years or older when undergoing the procedure. * the subject has signed the informed consent. * the subject signed informed consent dated back within 12 months and was implanted with biotronik orsiro sirolimus-eluting coronary stent system in stent implantation operation. exclusion criteria: * the subject has or had a life expectancy less then 12 month after treatment with biotronik orsiro sirolimus-eluting coronary stent system in stent implantation operation. * the subject has any known allergies to the following substances: aspirin, heparin/divalerythromycin, p2y12 inhibitors (clopidogrel/prasugrel/ticagrelor), bivalirudin, rapamycin, l-605 cobalt-chromium (co-cr) alloy or its main elements (cobalt, chromium, tungsten and nickel), acrylic acid, fluoropolymer, silicon carbide, plla allergy or contraindications. * the investigator judges that the subject has poor compliance and cannot complete the study as required, or other circumstances that are not suitable for participation in this study .

Keywords: orsiro biotronik china coronary stent system
long-term evaluation of direct pulp capping

Conditions: Dental Pulp Capping; Dental Caries Extending to Pulp

Summary: calcium hydroxide and mineral trioxide aggregate have been used in vital pulp therapy with variable outcomes recorded by different study. they will be compared when used for direct pulp capping in cariously exposed mature permanent teeth.

vital pulp therapy has the benefit of providing patients with a conservative treatment option with relatively low cost when compared to conventional root canal treatment and spares them possible post-treatment consequences that might occur. vital pulp treatment in trauma cases is associated with high success rate but controversy still exists regarding vital pulp treatment in carious-exposed pulp. the purpose of this study is to evaluate the success rate of direct pulp capping performed with mta-angelus® or calcium hydroxide in mechanical-exposed or carious-exposed mature permanent human teeth. patients included in this study will be recruited from routine dental patients attending conservative clinics in just dental teaching centre. adult patients scheduled for routine conservative treatment involving caries removal and restoration with mechanical or carious pulp exposure will be invited to participate in this study. a total of 80 carious human teeth with carious pulp exposure will be included in this randomized clinical study. patients are among those scheduled for conservative dental treatment and end with pulp exposure. the patients and/or their parents will be asked to sign a consent form after receiving a detailed explanation about the study rationale, clinical procedures, and possible risks. the exposed teeth will be divided randomly into two experimental groups (n=40) according to the dressing materials; mta-angelus® or calcium hydroxide, then teeth will be restored with permanent filling. teeth will be reviewed recording any signs and symptoms. patients will be reviewed in 1 week, 3 months and yearly after. mta-angelus and calcium hydroxide are anticipated to be biocompatible and induce hard tissue barrier. this project will reveal if tested materials are presented with promising profile upon using as direct pulp capping dressing in mechanical and carious-exposed pulp.

Eligibility criteria:
inclusion criteria: 1. carious teeth that had no previous root canal treatment 2. pulpal diagnosis of normal or reversible pulpitis exclusion criteria: 1. history of irreversible pulpal pain 2. immature teeth 3. non restorable teeth 4. teeth with active periodontal disease 5. history of any systemic disease 6. concurrent medication with systemic steroids, antibiotics, analgesics, immunomodulatory drugs or cytotoxics
evaluation of the effect of saffron (crocus sativus) on pain control after root canal therapy in teeth with vital pulps

Conditions: Post-treatment Pain Following Root Canal Therapy

Summary: the purpose of this study is to determine whether saffron is effective in the pain control after root canal therapy in vital teeth.

among patients refer to endodontics department of zahedan faculty of dentistry whom with moderate to severe pain in a single canal tooth will be selected and randomly divided in 2 groups of saffron and placebo. after root canal therapy each patient in each group will receive a box of 8 similar capsules. they will use 1 capsule exactly after treatment completion and then each 6 hours up to 48 hours. patients will record their pain intensity in each time period according to visual analog scale(vas)and finally mean pain intensity will be compared between 2 groups.

Eligibility criteria:
inclusion criteria: * patients who have at least one vital tooth with one root canal and moderate to severe pain exclusion criteria: 1. teeth with periapical lesions 2. patients with history of: * allergy to saffron * diabetes mellitus * cardiovascular disorders * kidney and liver diseases * blood and hormonal disorders * electrolyte imbalance 3. women in pregnancy or breast feeding period and 4. use of analgesics or opioids during 4 hours before treatment

Keywords: pain root canal therapy
prospective evaluation of femoral tripod eversion technique

Conditions: Atheromatous

Summary: endarteriectomy is considered as the first line treatment of femoral bifurcation atheromatous lesions. eversion technique, similar to that used for carotid bifurcation, is safe and possible for the majority of the femoral tripod lesions. the major advantage of the eversion technique is the absence of prosthetic material to be performed. however, its use has been scarcely evaluated in the literature to date. this work aims at evaluating the long term safety and the efficacy of eversion femoral technique. surgical technique was thoroughly described and participants were followed up for two years by serial clinical and doppler us examination.

femoral bifurcation lesions is one of the most frequent lesion encountered in lower limb atheromatous occlusive disease. current treatment options consists in femoral endarteriectomy or bypass. more recently, endovascular treatment of femoral tripod lesions has been reported. inguinal area is prone to postoperative infection in up to 20% of the cases. hence, the use of synthetic graft puts the participants at risk of dramatic consequences in case of postoperative infection. besides, long term data are still required to validate the use of endovascular device in this very "surgical" area. the use of the eversion technique is possible in the majority of the lesions and offer the major advantage of open surgery in terms of durability, without the use of synthetic material in case of postoperative infection. the investigators herein report the detailed technique, tips and variations of the eversion technique as well as the clinical follow up in terms of clinical benefit according to rutherford classification and restenosis evaluated by serial doppler us.

Eligibility criteria:
inclusion criteria: * age\>18 years * lower limb atheromatous occlusive disease. * stage 2 to 4 according to rutherford's classification exclusion criteria: * age\< 18 * previous surgery or endovascular treatment of the ipsilateral limb * non atheromatous disease * pregnancy * life-expectancy estimated to be less than one year

Keywords: femoral bifurcation peripheral arterial disease vascular surgery eversion open surgery
integrative couple treatment for pathological gambling

Conditions: Pathological Gambling

Summary: the aim of the study is to compare marital treatment to individual treatment for pathological gambling.

the study as two goals: evaluate the efficacy of couple treatment for pathological gambling and develop a better understanding of the individual (substance use, mental health) and couple dimensions (communication, marital satisfaction, violence) as intermediate variables explaining this efficacy. couples will be randomized between the couple treatment and the treatment as usual (individual or group). the experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. the couple treatment called (integrative couple therapy for pathological gambling - ict-pg) is inspired by the "alcohol behavior couple therapy" from epstein and mccrady, to which the team added diverse components to adjust to gamblers. during the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support). the control group receives individual or group treatment as already offered by the specialized centers in addiction. their partner can receive individual intervention if desired. all participants are recruited in specialized addiction treatment centers in quebec province, canada. evaluation of participants is done at admission, three, nine and 18 months post-admission. repeated measures anova will be used to compared evolutions of groups over time. multiple regression will allow the estimation of components roles into as intermediate variables to predict rehabilitation.

Eligibility criteria:
inclusion criteria: * living together for at least 1 year * diagnosis of pathological gambling (wmh-cidi) during the last 12 months * the gambler has not received treatment for their gambling for at least 6 months (excluding ga) * presence of gambling behavior in the past 3 months * degree of commitment to the couple indicating a desire to continue the relationship (score of 7 - msi) exclusion criteria: * alcohol/drug dependence gambler/partner (severity of alcohol dependence data questionnaire - sadd \>17 included in deba-a; severity of dependence scale - sds \> 5 included in deba-d) * gambling problem for the partner (deba-jeu \> 10) * presence of serious acts of violence endangering the safety of both spouses (cts-2) * disorder and serious mental health unstabilized one of two members of the couple (asi: psychological scale) * antisocial personality disorder or severe limit ( gain: 9 + scale bcs / cds) * scenario with strong suicidal ideation or attempt in the last 30 days or less in the partner (asi: psychological scale) * low degree of commitment in the relationship of a risk of separation (8 + msi)

Keywords: pathological gambling treatment marital relationship
the effect of left ventricular filling pressure on pulmonary clearance of free radical loaded white blood cells and platelets in congestive heart failure patients before and after biventricular pacing

Conditions: Congestive Heart Failure

Summary: 1. to assess whether a correlation exist between the degree of pulmonary clearance of free radical positive white bloodcells and platelets and the degree of pulmonary congestion in congestive heart failure (chf) patients 2. to asses whether cardiac resynchronization therapy improves pulmonary clearance of free radical positive white blood cells and platelets in chf patients by alleviating pulmonary congestion 3. interaction of oxidative stress with circulating endothelial progenitor cells (epcs) and presence of apoptotic endothelial (progenitor) cells

evidence exists that oxidative stress is enhanced in congestive heart failure patients resulting in damage to cellular lipids, proteins and dna. because of free radical-induced apoptosis of skeletal muscle fibers, oxidative stress is an important contributor to skeletal muscle fatigue and low exercise tolerance of congestive heart failure patients. enhanced oxidative stress in congestive heart failure can exert negative inotropic effects and can have important effects on the structure and function of the myocardium, and may be implicated in the progression of congestive heart failure. free radical stress could also impair recruitment and differentiation of circulating endothelial progenitor cells resulting in increased all cause mortality. reduced pulmonary clearance of free radical loaded white blood cells and platelets is an important contributor to enhanced oxidative stress in congestive heart failure patients. failure of pulmonary clearance of free radical loaded white blood cells and platelets probably results from pulmonary congestion which has led to the rationale of the current study. biventricular pacing for resynchronization therapy in congestive heart failure patients reduces left ventricular filling pressure and pulmonary congestion. biventricular pacing may therefore augment pulmonary clearance of free radical loaded white blood cells and platelets in congestive heart failure patients. we conduct a prospective, observational clinical study to investigate the correlation of left ventricular filling pressure, pulmonary clearance of fr loaded circulating white blood cells and platelets and number of endothelial progenitor cells in congestive heart failure (chf) patients before and after implantation of a biventricular pacemaker for resynchronization therapy.

Eligibility criteria:
patient selection informed consented participants are recruited among all patients admitted to the olvg hospital. inclusion criteria: * chronic congestive heart failure patients of all ages selected for biventricular pacemaker implantation for resynchronization therapy * dyspnoe nyha class iii and iv * optimal and constant heart failure treatment according to the esc guidelines exclusion criteria: * renal failure (creatinine \> 1.70 mg/dl) * signs of infection or inflammation

Keywords: heart failure oxidative stress endothelial progenitor cells white blood cells
efficacy and safety study of gb-0998 for treatment of steroid-resistant polymyositis and dermatomyositis (pm/dm)

Conditions: Polymyositis; Dermatomyositis

Summary: this randomized, double-blind, placebo-controlled trial will carry out to assess the efficacy of gb-0998 in the treatment of the steroid-resistant polymyositis and dermatomyositis based on the changes in manual muscle strength (mmt) scores as primary endpoint, and in addition, to assess the safety of gb-0998.


Eligibility criteria:
inclusion criteria: * patients who have been defined as "definite" based on the criteria of bohan and peter for polymyositis and dermatomyositis. * patients who are defined as steroid-resistant ones based on the changes of scores on manual muscle testing (mmt) and serum levels of creatine kinase (ck) during observation period before administration of drug. exclusion criteria: * patients with malignant tumors. * patients with acute interstitial pneumonia, including acute exacerbation of chronic. * patients with severe muscular atrophy for a long period. * patients with severe infectious disease. * patients who have the anamnesis of shock or hypersensitivity to this drug. * patients with severe hepatic disorder or severe renal disorder. * patients who have the anamnesis of cerebral infarction or ischemic heart disease, or who having symptom of these diseases. * patients who have been diagnosed as iga deficiency in their past history. * pregnant, lactating, and probably pregnant patients, and patients who want to become pregnant. * patients who were administered immunoglobulin dosage within 6 weeks before consent.

Keywords: polymyositis, dermatomyositis high-dose intravenous immunoglobulin venoglobulin-ih steroid-resistant polymyositis(pm) and dermatomyositis(dm)